Provider Demographics
NPI:1164167938
Name:HOMEAGLOW
Entity Type:Organization
Organization Name:HOMEAGLOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FULL-TIME
Authorized Official - Prefix:
Authorized Official - First Name:OMINEY
Authorized Official - Middle Name:LATUAN
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-573-3725
Mailing Address - Street 1:2711 CENTERVILLE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:145 SUE CT
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-1023
Practice Address - Country:US
Practice Address - Phone:708-573-3725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care